Nutrition plays a key role in health maintenance, weight management and chronic disease prevention. However, adherence to the dietary recommendations in the U.S. is poor. Similarly, global dietary patterns are also less than optimal; in many countries, people consume more than 500 calories from added sugars per day. In the U.S., half of the population consumes sugar-sweetened beverages (SSBs) on any given day, with a quarter of the population consuming over 200 calories from SSBs daily. In addition, the average dietary intake of calories in the U.S. in 2010 was nearly 2,600 calories per person per day, which is a 25% increase in energy intake since 1970. Consumption of flour and cereal products, added fats and oils, and added sugars and sweeteners are some of the chief contributors to the increase in caloric intake.

Together with physical inactivity, poor diet is a major contributor to the U.S. overweight (Body Mass Index (BMI) of 25-29.9) and obesity (BMI over 30) epidemic, increasing the risk of cardiovascular disease, diabetes and cancer. Over two thirds (69%) of all American adults (20 years and older) today are overweight, and more than a third (35%) are obese. The situation is similar worldwide, with more than 1.9 billion (39%) adults overweight in 2014, of which over 600 million (13%) were obese, making obesity not just an epidemic but a global pandemic.

Suboptimal dietary patterns can also lead to other detrimental health outcomes. For example, high consumption of SSBs has been linked to diabetes, metabolic syndrome, obesity, hypertension, dental caries and even depression. High intake of red and processed meat is associated with heart failure, hypertension, coronary heart disease, and colorectal and breast cancers. Moreover, low fruit and vegetable consumption is associated with a higher rate of type 2 diabetes, cardiovascular mortality, as well as breast and gastrointestinal cancers. The World Health Organization (WHO) reports that 2.7 million deaths worldwide are attributed to insufficient fruit and vegetable intake, making it one of the top 10 risk factors contributing to global mortality.

While the components and ingredients that often make up our foods represent a significant and reasonable concern, another issue is the changes in cultural food practices. Busy lives and longer workdays are encouraging unhealthy behaviors, including eating meals on the go and in front of the TV, snacking between meals and eating large portion meals. Further, high-fat, high-sugar snack foods of low nutritional quality are engineered to be tastier, with potentially addictive qualities. These foods are often supported by colorful and enticing advertisements that inundate our environments, from vending machines to restaurants and supermarket shelves. In the U.S. alone, more than $1.6 billion is spent annually by the food industry specifically marketing cereal, fast-food and soft drinks to children and adolescents, which, according to the Institute of Medicine (IOM), is “out of balance with recommended healthful diets”, contributing to unhealthy dietary patterns and putting the health of the American youth at risk.

Fortunately, food purchase and consumption decisions, dietary patterns and preparation practices all represent not only points of concern, but also venues for health improvement. A variety of social, economic, physiological and environmental factors can affect individual dietary behaviors; the built environment is one of them. Distance and access to grocery stores and other places that have fresh fruits and vegetables, access to farmers’ markets, the use of behavioral economics in cafeterias, increased availability of healthy foods and reduced marketing and availability of unhealthy foods, provision of caloric information and many other strategies can have an effect on our food choices and overall dietary patterns. The WELL Building Standard® recognizes this and seeks to implement design strategies and policies.